How to Hire and Keep Good People in a Medical Practice

October 10, 2007

Hiring and retaining a good staff is a BIG issue for all medical practices. Why? The obvious reason is that the talent pool of qualified people to work in a medical practice is shrinking. In some areas, the pool of available talent is very small or almost non-existent. This is why it is so important to find good people and when they are hired, to make sure you or your client keeps them. If a practice cannot find and keep good people, it is almost guaranteeing itself problems not only in the present, but surely in the future. This article speaks to the issues of hiring and keeping good people.

Turnover is Costly

We all know the actual and hidden costs to replace an employee. Some costs of unplanned turnover include:

  • Departing employees costs (vacation pay and other benefits);
  • Advertising for the new position;
  • Management interviewing time for the new employee;
  • Conducting background checks (driving, criminal, etc.);
  • The time it takes to train the new employee;
  • The new employee’s initial low productivity;
  • Unbudgeted overtime for staff covering the empty position while it is being replaced;
  • Possible low morale of remaining staff and its related impact on productivity – staff becomes overworked and stressed during this time.

Hiring Good People

The following are a few tips on how to hire good people. Many medical practices however do not conduct these extensive activities before hiring a new person.

Tip – obtain a signed release that will enable you to obtain complete reference checks  This will allow you to check for all aspects of the applicant’s background. The following are examples of what the practice may want to check out – I have seen employees “fudge” on each one of them at one point or another:

  • Credit check – if bad credit exists, prospective employee could be an embezzlement target, depending of course on the position;
  • Driving record – big issue if prospective employee will have to run many errands for the practice;
  • Educational record – big red flag if items are not confirmed or have been omitted here;
  • Criminal check – the reason for this should be obvious!; and
  • Workers’ Compensation check – is this the type of person who has in the past filed many claims against his or her employers?

Tip – test basic skills  Test skills such as attention to detail, grammar, punctuation, numerical skills, etc. Just because an employee presents himself or herself well does not mean they have these basic skills.

Tip – make prospect complete and sign an employee application  Look for gaps in past employment and  is also useful to compare with prospective employee’s resume for any differences.

Tip – use “situational” interviewing questions  Pick questions that will open up the potential employee in a way that will show how capable he or she is for the position being hired. For example, if the practice is hiring a billing person, ask specific questions about the applicant’s knowledge of Medicare billing rules, CPT, modifiers, filing claims electronically, etc. Even better yet, ask situational questions. This means asking a hypothetical and asking the applicant to respond to it. Here is an example for a biller for a surgery practice: Surgical practice bills an office visit on the same day as a procedure. The insurance company would not pay for the office visit. Why?

In addition, the practice may want the applicant to speak with the practice’s independent CPA and/or healthcare consultant. This secondary line of interviewing might be able to spot issues the practice’s personnel might not have been able to detect.

Tip – job fit testing  Many tests are available with immediate scoring via Internet testing capability. Your homework must be done first on the position needs to get accurate results though. For an example, go to

Tip – pay fair market salaries  Don’t be cheap – you get what you pay for. Pay current fair market value within the practice’s service area for the position being recruiting. It’s that simple. In addition, the practice should have a decent employee benefit package, which could include health insurance, retirement plan, 401k matching, personal leave, and reasonable sick and vacation days.

Keeping Good Employees

Step number one: Treat them well. Now that the practice has filled the position, it must make sure to keep the hired employee for long time. However, as we all know, turnover is a big issue for many medical offices. To begin this process, practices should keep the following management principles in mind:

1. Nothing will drive employees away faster than a boss who is – or even appears to be – unapproachable or disrespectful.

2. Employees want to make a difference. They want to be proud of where they work. They want to succeed.

3. Without someone on the sidelines cheering employees on, enthusiasm soon fades. Productivity generally follows suit.

4. People are motivated by recognition. Anything the practice can do to recognize them will make them work a little harder. It also helps them stay put.

5. Bosses in medical practices should treat people like they want to be treated. If people feel they are needed, wanted and respected, they’re going to stay and the practice is going to get their loyalty.

6. Help employees be the best he/she can be on an ongoing basis.

These were just a few simple, daily management ideas to keep good people. However, this is just a start. Here are some more ——

Provide Adequate Educational Seminar Opportunities

Make sure all employees are kept up to date in their practice area. This is especially true for the office’s CPT coder(s).

Make Sure the Office is Adequately Staffed

It should be a requirement that all medical practice departments be adequately staffed. However, in the era of declining reimbursement, it seems some medical offices are cutting staff, much to their own detriment. This in almost all cases results in a decline in employee morale. If necessary to keep staff, the medical office should be creative with its human resource. This includes using flex hours, home workers, cross coverage, etc.

Be Appreciative of Staff

People are motivated by recognition. Anything the medical office can do to recognize them will make them work a little harder. Believe it or not, it also helps them stay put.  The following are some ideas for employee recognition:

  • Personal notes from management for exceptional work.
  • Employee outings.
  • A verbal “thank you.”
  • Gifting.

Conduct Employee Reviews

Reviews should be annually and periodically at designated times throughout the year. These should be productive, training sessions. Have employees set goals and monitor these goals throughout the year. Employers with good review programs, coupled with ongoing training and mentoring, seem to have the lowest turnover rate among its employee group.

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